Background: The Cancer Genome Atlas (TCGA) Research Network revealed numerous clear cell renal ce... more Background: The Cancer Genome Atlas (TCGA) Research Network revealed numerous clear cell renal cell carcinoma (ccRCC) gene mutations among which titin (TTN). The link between excessive amounts of visceral adipose tissue (VAT) and ccRCC pathogenesis is known. A relationship between VHL and TTN gene mutations and a CT-derived estimation of body composition in ccRCC patients has been evaluated. Methods: We retrospectively assessed patients from the TCGA-kidney renal clear cell carcinoma (KIRC) database for evaluation of clinicopathological and body composition analysis of ccRCC VHL and TTN gene mutations. Results: Gene expression levels and survival were assessed on a large cohort of 483 patients and 533 tumor samples. A statistically significant difference of VHL expression reduction in primary tumor (p < 0.0001) and a TTN expression increase in primary tumor (p < 0.0001) was shown. TTN high expression levels was associated with statistically significant lower KIRC patient survival at eight years (p < 0.05). For body composition analysis, we included 54 male patients divided into two groups: ccRCC-VHL (n = 41) and ccRCC-TTN (n = 13) groups. Statistically significant differences between the two groups were obtained for total adipose tissue (TAT) (p < 0.01), VAT (p < 0.05), subcutaneous adipose tissue (SAT) (p < 0.05) and total abdominal muscle (TAM) (p < 0.05) areas. Conclusion: This study demonstrates a link between ccRCC TTN gene mutation and shorter patient survival. The reduction of the analyzed tissues might be a risk of cancer cachexia in ccRCC patients with TTN gene mutation.
Background: To evaluate the clinical utility of an Artificial Intelligence (AI) radiology solutio... more Background: To evaluate the clinical utility of an Artificial Intelligence (AI) radiology solution, Quantib Prostate, for prostate cancer (PCa) lesions detection on multiparametric Magnetic Resonance Images (mpMRI). Methods: Prostate mpMRI exams of 108 patients were retrospectively studied. The diagnostic performance of an expert radiologist (>8 years of experience) and of an inexperienced radiologist aided by Quantib software were compared. Three groups of patients were assessed: patients with positive mpMRI, positive target biopsy, and/or at least one positive random biopsy (group A, 73 patients); patients with positive mpMRI and a negative biopsy (group B, 14 patients), and patients with negative mpMRI who did not undergo biopsy (group-C, 21 patients). Results: In group A, the AI-assisted radiologist found new lesions with positive biopsy correlation, increasing the diagnostic PCa performance when compared with the expert radiologist, reaching an SE of 92.3% and a PPV of 90.1% (vs. 71.7% and 84.4%). In group A, the expert radiologist found 96 lesions on 73 mpMRI exams (17.7% PIRADS3, 56.3% PIRADS4, and 26% PIRADS5). The AI-assisted radiologist found 121 lesions (0.8% PIRADS3, 53.7% PIRADS4, and 45.5% PIRADS5). At biopsy, 33.9% of the lesions were ISUP1, 31.4% were ISUP2, 22% were ISUP3, 10.2% were ISUP4, and 2.5% were ISUP5. In group B, where biopsies were negative, the AI-assisted radiologist excluded three lesions but confirmed all the others. In group-C, the AI-assisted radiologist found 37 new lesions, most of them PIRADS 3, with 32.4% localized in the peripherical zone and 67.6% in the transition zone. Conclusions: Quantib software is a very sensitive tool to use specifically in high-risk patients (high PIRADS and high Gleason score).
Background: peritumoral collateral vessels adjacent to renal cell carcinoma (RCC) can be encounte... more Background: peritumoral collateral vessels adjacent to renal cell carcinoma (RCC) can be encountered in clinical practice. Cancer cachexia is defined as a decrease of adipose and skeletal muscle tissues. In this study we evaluated, using a quantitative CT imaging-based approach, the distribution of abdominal adipose tissue in clear cell RCC (ccRCC) male patients with and without collateral vessels. Methods: between November 2019 and February 2020, in this retrospective study we enrolled 106 ccRCC male Caucasian patients divided into two groups: a ccRCCa group without collateral vessels (n = 48) and a ccRCCp group with collateral vessels (n = 58). The total adipose tissue (TAT), visceral adipose tissue (VAT) and subcutaneous adipose tissue (SAT) areas were measured in both groups. Moreover, the VAT/SAT ratio was calculated for each subject. Results: a statistically significant difference between the two groups was found in the SAT area (p < 0.05), while no significant differences were found in the TAT area, VAT area and VAT/SAT ratio. Conclusion: this study demonstrates a reduction of SAT in ccRCC patients with peritumoral collateral vessels.
Ultrasound (US)-guided minimally-invasive techniques, such as radiofrequency ablation (RFA) have ... more Ultrasound (US)-guided minimally-invasive techniques, such as radiofrequency ablation (RFA) have emerged as an alternative treatment to surgery for benign and malignant thyroid nodules. Based on a systematic literature search, here we report the long-term outcomes of thyroid RFA. Available data show that US-guided RFA significantly reduced benign thyroid nodules and destroyed most PTMC, and this was generally maintained for at least 5 years after the initial treatment. Further studies addressing the risk of regrowth in patients with benign thyroid nodules, as well as the risk of recurrence in patients with PTMC are needed.
Background: The aim of this study was to investigate whether the presence of peritumoral collater... more Background: The aim of this study was to investigate whether the presence of peritumoral collateral vessels could be indicative of a high Fuhrman grade (e.g., III and IV) in clear cell renal cell carcinoma (ccRCC). Methods: Between November 2019 and February 2020, a total of 267 ccRCC patients with histology-proven diagnoses were retrospectively analyzed and screened. Imaging analysis was performed on computed tomography (CT) images to assess the presence of peritumoral collateral vessels and understand the potential association with high Fuhrman grades. These vessels are defined as dilated and macroscopically visible peritumoral renal capsular veins. Results: A total of 190 ccRCC patients were included in the study, considering the exclusion criteria. In patients with peritumoral collateral vessels, there was a statistically significant greater presence of ccRCC with a high Fuhrman grade both among the total cohort of patients regardless gender (n = 190) (p < 0.001) as well as a...
Quantitative Imaging in Medicine and Surgery, 2021
Background: The primary objective of this study was to compare measurements of skeletal muscle in... more Background: The primary objective of this study was to compare measurements of skeletal muscle index (SMI), visceral adipose tissue (VAT) and subcutaneous adipose tissue (SAT) at the level of L3, on subjects who underwent computed tomography (CT) and magnetic resonance imaging (MRI) examinations within a three-month period. The secondary objective was to compare the automatic and semi-automatic quantifications of the same values for CT images. Methods: Among subjects who underwent CT and MRI at our Institution between 2011 and 2020, exclusion criteria were: presence of extensive artifacts; images not including the whole waist circumference; CT acquired with low-dose technique and lack of non-contrast images. A set of three axial images (CT, MRI T1-weighted and T2-weighted) were used to extract the following measurements with semi-automatic segmentations: SMI [calculated normalizing skeletal muscle area (SMA) by the square height], SAT, VAT. For the CT images only, the same values were also calculated by using automatic segmentation. Statistical analysis was performed comparing quantitative MRI and CT measurements by Pearson correlation analysis and by Bland-Altman agreement analysis. Results: A total of 123 patients were included. By performing linear regression analysis, CT and MRI measurements of SMI showed a high correlation (r 2 =0.81 for T1, r 2 =0.89 for T2), with a mean logarithmic difference between CT and MRI quantitative values of 0.041 for T1-weighted and 0.072 for T2-weighted images. CT and MRI measurements of SAT showed high correlation (r 2 =0.81 for T1; r 2 =0.81 for T2), with a mean logarithmic difference between CT and MRI values of 0.0174 for T1-weighted and 0.201 for T2weighted images. CT and MRI measurements of VAT showed high correlation (r 2 =0.94 for T1; r 2 =0.93 for T2), with a mean logarithmic difference of 0.040 for T1-weighted and -0.084 for T2-weighted images. The comparison of values extracted by semi-automatic and automatic segmentations were highly correlated. Conclusions: Quantification of body composition values at MRI from T1-weighted and T2-weighted images was highly correlated to same values at CT, therefore quantitative values of body composition among ^ ORCID: 0000-0002-5151-0866.
Background: to evaluate the contribution of edema associated with histological features to the pr... more Background: to evaluate the contribution of edema associated with histological features to the prediction of breast cancer (BC) prognosis using T2-weighted MRI radiomics. Methods: 160 patients who underwent staging 3T-MRI from January 2015 to January 2019, with 164 histologically proven invasive BC lesions, were retrospectively reviewed. Patient data (age, menopausal status, family history, hormone therapy), tumor MRI-features (___location, margins, enhancement) and histological features (histological type, grading, ER, PgR, HER2, Ki-67 index) were collected. Of the 160 MRI exams, 120 were considered eligible, corresponding to 127 lesions. T2-MRI were used to identify edema, which was classified in four groups: peritumoral, pre-pectoral, subcutaneous, or diffuse. A semi-automatic segmentation of the edema was performed for each lesion, using 3D Slicer open-source software. Main radiomics features were extracted and selected using a wrapper selection method. A Random Forest type classif...
Bones are a frequent site of metastases that cause intolerable cancer-related pain in 90% of pati... more Bones are a frequent site of metastases that cause intolerable cancer-related pain in 90% of patients, making their quality of life poor. In this scenario, being able to treat bone oncology patients by means of minimally invasive techniques can be crucial to avoid surgery-related risks and decrease hospitalization times. The use of microwave ablation (MWA) is gaining broad clinical acceptance to treat bone tumors. It is worth investigating temperature variations in bone tissue undergoing MWA because the clinical outcomes can be inferred from this parameter. Several feasibility studies have been performed, but an experimental analysis of the temperature trends reached into the bone during the MWA has not yet been assessed. In this work, a multi-point temperature study along the bone structure during such treatment is presented. The study has been carried out on ex vivo bovine femur and tibia, subjected to MWA. An overall of 40 measurement points covering a large sensing area was obta...
Angiomyolipoma is a type of benign renal tumor. It is sporadic and isolated in 80% of cases. The ... more Angiomyolipoma is a type of benign renal tumor. It is sporadic and isolated in 80% of cases. The remaining 20% is associated with tuberous sclerosis complex or pulmonary lymphangioleiomyomatosis. Generally, angiomyolipomas manifest themselves as angiomyolipomatosis, in which the angiomyolipomas are larger, bilateral, and widespread. Understanding whether angiomyolipomas are present in the context of angiomyolipomatosis is of considerable importance because it might be associated with malignant lesions. This article provides an overview of the radiological features of renal angiomyolipomatosis under different imaging techniques such as ultrasound, computed tomography, and magnetic resonance.
European Journal of Surgical Oncology (EJSO), 2015
Objective-The aim of the present study was to assess the temperature map and its reproducibility ... more Objective-The aim of the present study was to assess the temperature map and its reproducibility while applying two different MWA systems (915 MHz vs 2.45 GHz) in ex vivo porcine livers. Materials and Methods-Fifteen fresh pig livers were treated using the two antennae at three different settings: treatment time of 10 minutes and power of 45 W for both systems; 4 minutes and 100 W for the 2.45 GHz system. Trends of temperature were recorded during all procedures by means of fiber optic-based probes located at five fixed distances from the antenna, ranging between 10 mm and 30 mm. Each trial was repeated twice to assess the reproducibility of temperature distribution. Results-Temperature as function of distance from the antenna can be modeled by a decreasing exponential trend. At the same settings, temperature obtained with the 2.45 GHz system was higher than that obtained with the 915MHz thus resulting into a wider area of ablation (diameter 17mm vs 15mm). Both systems showed good reproducibility in terms of temperature distribution (root mean squared difference for both systems ranged between 2.8 °C and 3.4 °C).
We present a case of double prosthetic replacement of the right pulmonary artery and superior ven... more We present a case of double prosthetic replacement of the right pulmonary artery and superior vena cava combined with upper sleeve bilobectomy for a limited pT4N1 adenocarcinoma occurring in a patient with poor pulmonary reserve, which, to the best of our knowledge, has never been reported before.
Bone metastases and osteoid osteoma (OO) have a high incidence in patients facing primary lesions... more Bone metastases and osteoid osteoma (OO) have a high incidence in patients facing primary lesions in many organs. Radiotherapy has long been the standard choice for these patients, performed as stand-alone or in conjunction with surgery. However, the needs of these patients have never been fully met, especially in the ones with low life expectancy, where treatments devoted to pain reduction are pivotal. New techniques as hyperthermia treatments (HTs) are emerging to reduce the associated pain of bone metastases and OO. Temperature monitoring during HTs may significantly improve the clinical outcomes since the amount of thermal injury depends on the tissue temperature and the exposure time. This is particularly relevant in bone tumors due to the adjacent vulnerable structures (e.g., spinal cord and nerve roots). In this Review, we focus on the potential of temperature monitoring on HT of bone cancer. Preclinical and clinical studies have been proposed and are underway to investigate the use of different thermometric techniques in this scenario. We review these studies, the principle of work of the thermometric techniques used in HTs, their strengths, weaknesses, and pitfalls, as well as the strategies and the potential of improving the HTs outcomes.
IEEE journal of electromagnetics, RF and microwaves in medicine and biology, 2024
Thyroid nodules represent a widespread health concern and surgery is often adopted even if the in... more Thyroid nodules represent a widespread health concern and surgery is often adopted even if the incidence of frequent post-operative complications is not negligible. In recent years, this framework has fostered the growing spread of thermal ablation treatments, in particular microwave ablation (MWA). To date, despite its relevance, state-of-the-art regarding temperature monitoring in thyroid tissue during MWA is lacking. In this paper, the effects of MWA in thyroid by monitoring temperatures have been explored. By using several fiber Bragg gratings (FBGs) temperature sensors, the heat maps in the proximity of the MW antenna have been reconstructed for two different power values set at generator. An increase up to about 4.5 cm 3 in ablation volume and up to 24°C in maximum temperature variation as power rises from 20 W to 30 W has been observed. In addition, the dependency of the temperature evolution on the involved power has been investigated, observing that, with increasing power, some FBGs recorded a ΔT slope increase until the maximum values, resulting in shorter ablation times, and others recorded a plateau phase until the end of the MWA treatment. Such a propensity could be relevant to adjust the clinical settings according to the desired treatment outcome.
Aim: To evaluate the capability of non-enhanced breast MRI to assess flap volume variability in p... more Aim: To evaluate the capability of non-enhanced breast MRI to assess flap volume variability in post-bariatric patients who underwent mastopexy in a reproducible way. Materials and Methods: Ten bariatric patients, treated with mastopexy using anterior intercostal artery perforator (AICAP) flap for autologous tissue breast augmentation, were enrolled in this study. All patients performed a breast Magnetic Resonance (MR) exam after surgery, in a period ranged from 177 and 838 days. The real flap volume, measured before mastopexy, and the flap volume calculated from MRI segmentation, was compared. Two radiologists performed the segmentation of the flap and of the whole breast, manually drawing an area of interest on MR images. The process was repeated for each patient, each breast and each slice 5 times, on axial T2W-TIRM, axial T1W-3D FS and sagittal T1W-3D images. Then, the flap and the breast 3D volumes were automatically generated combining multiple segmentations. The reproducibility of the measurements was evaluated, analyzing inter-and intra-observer agreement, and the most accurate MRI sequence was identified. Results: A significant difference between the mean flap volume before mastopexy and the mean MRI flap volume was detected, with an absolute mean decrease of 46,85% (105,89 cm 3) (p<0.05). There was no significant difference among the measurements performed by the same reader and by the two readers. The lowest variability was identified on T1W-FS, evaluated as the best performing sequences. Conclusion: MRI breast segmentation is an accurate and reproducible method for breast flap volume assessment and can provide important quantitative information to surgeons.
This article is an open access article distributed under the terms and conditions of the Creative... more This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY
This article is an open access article distributed under the terms and conditions of the Creative... more This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY
Background: The diffusion of lung cancer screening programs has increased the detection of both s... more Background: The diffusion of lung cancer screening programs has increased the detection of both solid and ground-glass opacity (GGO) sub-centimetric lesions, leading to the necessity for histological diagnoses. A percutaneous CT-guided biopsy may be challenging, thus making surgical excision a valid diagnostic alternative. CT-guided hydrogel plug deployment (BioSentry®) was recently proposed to simplify intraoperative nodule localization. Here, we report our initial experience. Methods: We evaluated 62 patients with single, small, peripheral, non-subpleural pulmonary GGO that was suspicious for cancer. All lesions were preoperatively marked, using CT-guidance, with a hydrogel plug (BioSentry®). Then, a uniportal video-assisted thoracoscopy (uniVATS) wedge resection was performed. If cancer was confirmed at the frozen section, a major lung resection was then performed. The study’s end points were the rates of intraoperative localization and of successful resection. Results: The hydro...
This article is an open access article distributed under the terms and conditions of the Creative... more This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY
Background: Percutaneous CT-guided cryoablation is an emerging technique for treating bone tumors... more Background: Percutaneous CT-guided cryoablation is an emerging technique for treating bone tumors. However, experience with using this procedure for osteoid osteomas in pediatric patients remains limited. Our study aims to assess its technical feasibility, clinical efficacy, and safety in children treated under conscious anesthesia. Methods: We conducted a retrospective study of consecutive pediatric patients who underwent CT-guided percutaneous cryoablation for osteoid osteomas at our institution between September 2017 and March 2021. All patients received conscious anesthesia. Data on peri-procedural VAS scores, post-procedural VAS scores, imaging findings, and nonsteroidal anti-inflammatory drug (NSAID) usage rates were collected for each patient. Technical success was defined as proper cryoprobe placement at the nidus center, while clinical success referred to pain relief without NSAID use. Intra- and post-operative complications were also evaluated. Results: Nine patients under...
Background: The Cancer Genome Atlas (TCGA) Research Network revealed numerous clear cell renal ce... more Background: The Cancer Genome Atlas (TCGA) Research Network revealed numerous clear cell renal cell carcinoma (ccRCC) gene mutations among which titin (TTN). The link between excessive amounts of visceral adipose tissue (VAT) and ccRCC pathogenesis is known. A relationship between VHL and TTN gene mutations and a CT-derived estimation of body composition in ccRCC patients has been evaluated. Methods: We retrospectively assessed patients from the TCGA-kidney renal clear cell carcinoma (KIRC) database for evaluation of clinicopathological and body composition analysis of ccRCC VHL and TTN gene mutations. Results: Gene expression levels and survival were assessed on a large cohort of 483 patients and 533 tumor samples. A statistically significant difference of VHL expression reduction in primary tumor (p < 0.0001) and a TTN expression increase in primary tumor (p < 0.0001) was shown. TTN high expression levels was associated with statistically significant lower KIRC patient survival at eight years (p < 0.05). For body composition analysis, we included 54 male patients divided into two groups: ccRCC-VHL (n = 41) and ccRCC-TTN (n = 13) groups. Statistically significant differences between the two groups were obtained for total adipose tissue (TAT) (p < 0.01), VAT (p < 0.05), subcutaneous adipose tissue (SAT) (p < 0.05) and total abdominal muscle (TAM) (p < 0.05) areas. Conclusion: This study demonstrates a link between ccRCC TTN gene mutation and shorter patient survival. The reduction of the analyzed tissues might be a risk of cancer cachexia in ccRCC patients with TTN gene mutation.
Background: To evaluate the clinical utility of an Artificial Intelligence (AI) radiology solutio... more Background: To evaluate the clinical utility of an Artificial Intelligence (AI) radiology solution, Quantib Prostate, for prostate cancer (PCa) lesions detection on multiparametric Magnetic Resonance Images (mpMRI). Methods: Prostate mpMRI exams of 108 patients were retrospectively studied. The diagnostic performance of an expert radiologist (>8 years of experience) and of an inexperienced radiologist aided by Quantib software were compared. Three groups of patients were assessed: patients with positive mpMRI, positive target biopsy, and/or at least one positive random biopsy (group A, 73 patients); patients with positive mpMRI and a negative biopsy (group B, 14 patients), and patients with negative mpMRI who did not undergo biopsy (group-C, 21 patients). Results: In group A, the AI-assisted radiologist found new lesions with positive biopsy correlation, increasing the diagnostic PCa performance when compared with the expert radiologist, reaching an SE of 92.3% and a PPV of 90.1% (vs. 71.7% and 84.4%). In group A, the expert radiologist found 96 lesions on 73 mpMRI exams (17.7% PIRADS3, 56.3% PIRADS4, and 26% PIRADS5). The AI-assisted radiologist found 121 lesions (0.8% PIRADS3, 53.7% PIRADS4, and 45.5% PIRADS5). At biopsy, 33.9% of the lesions were ISUP1, 31.4% were ISUP2, 22% were ISUP3, 10.2% were ISUP4, and 2.5% were ISUP5. In group B, where biopsies were negative, the AI-assisted radiologist excluded three lesions but confirmed all the others. In group-C, the AI-assisted radiologist found 37 new lesions, most of them PIRADS 3, with 32.4% localized in the peripherical zone and 67.6% in the transition zone. Conclusions: Quantib software is a very sensitive tool to use specifically in high-risk patients (high PIRADS and high Gleason score).
Background: peritumoral collateral vessels adjacent to renal cell carcinoma (RCC) can be encounte... more Background: peritumoral collateral vessels adjacent to renal cell carcinoma (RCC) can be encountered in clinical practice. Cancer cachexia is defined as a decrease of adipose and skeletal muscle tissues. In this study we evaluated, using a quantitative CT imaging-based approach, the distribution of abdominal adipose tissue in clear cell RCC (ccRCC) male patients with and without collateral vessels. Methods: between November 2019 and February 2020, in this retrospective study we enrolled 106 ccRCC male Caucasian patients divided into two groups: a ccRCCa group without collateral vessels (n = 48) and a ccRCCp group with collateral vessels (n = 58). The total adipose tissue (TAT), visceral adipose tissue (VAT) and subcutaneous adipose tissue (SAT) areas were measured in both groups. Moreover, the VAT/SAT ratio was calculated for each subject. Results: a statistically significant difference between the two groups was found in the SAT area (p < 0.05), while no significant differences were found in the TAT area, VAT area and VAT/SAT ratio. Conclusion: this study demonstrates a reduction of SAT in ccRCC patients with peritumoral collateral vessels.
Ultrasound (US)-guided minimally-invasive techniques, such as radiofrequency ablation (RFA) have ... more Ultrasound (US)-guided minimally-invasive techniques, such as radiofrequency ablation (RFA) have emerged as an alternative treatment to surgery for benign and malignant thyroid nodules. Based on a systematic literature search, here we report the long-term outcomes of thyroid RFA. Available data show that US-guided RFA significantly reduced benign thyroid nodules and destroyed most PTMC, and this was generally maintained for at least 5 years after the initial treatment. Further studies addressing the risk of regrowth in patients with benign thyroid nodules, as well as the risk of recurrence in patients with PTMC are needed.
Background: The aim of this study was to investigate whether the presence of peritumoral collater... more Background: The aim of this study was to investigate whether the presence of peritumoral collateral vessels could be indicative of a high Fuhrman grade (e.g., III and IV) in clear cell renal cell carcinoma (ccRCC). Methods: Between November 2019 and February 2020, a total of 267 ccRCC patients with histology-proven diagnoses were retrospectively analyzed and screened. Imaging analysis was performed on computed tomography (CT) images to assess the presence of peritumoral collateral vessels and understand the potential association with high Fuhrman grades. These vessels are defined as dilated and macroscopically visible peritumoral renal capsular veins. Results: A total of 190 ccRCC patients were included in the study, considering the exclusion criteria. In patients with peritumoral collateral vessels, there was a statistically significant greater presence of ccRCC with a high Fuhrman grade both among the total cohort of patients regardless gender (n = 190) (p < 0.001) as well as a...
Quantitative Imaging in Medicine and Surgery, 2021
Background: The primary objective of this study was to compare measurements of skeletal muscle in... more Background: The primary objective of this study was to compare measurements of skeletal muscle index (SMI), visceral adipose tissue (VAT) and subcutaneous adipose tissue (SAT) at the level of L3, on subjects who underwent computed tomography (CT) and magnetic resonance imaging (MRI) examinations within a three-month period. The secondary objective was to compare the automatic and semi-automatic quantifications of the same values for CT images. Methods: Among subjects who underwent CT and MRI at our Institution between 2011 and 2020, exclusion criteria were: presence of extensive artifacts; images not including the whole waist circumference; CT acquired with low-dose technique and lack of non-contrast images. A set of three axial images (CT, MRI T1-weighted and T2-weighted) were used to extract the following measurements with semi-automatic segmentations: SMI [calculated normalizing skeletal muscle area (SMA) by the square height], SAT, VAT. For the CT images only, the same values were also calculated by using automatic segmentation. Statistical analysis was performed comparing quantitative MRI and CT measurements by Pearson correlation analysis and by Bland-Altman agreement analysis. Results: A total of 123 patients were included. By performing linear regression analysis, CT and MRI measurements of SMI showed a high correlation (r 2 =0.81 for T1, r 2 =0.89 for T2), with a mean logarithmic difference between CT and MRI quantitative values of 0.041 for T1-weighted and 0.072 for T2-weighted images. CT and MRI measurements of SAT showed high correlation (r 2 =0.81 for T1; r 2 =0.81 for T2), with a mean logarithmic difference between CT and MRI values of 0.0174 for T1-weighted and 0.201 for T2weighted images. CT and MRI measurements of VAT showed high correlation (r 2 =0.94 for T1; r 2 =0.93 for T2), with a mean logarithmic difference of 0.040 for T1-weighted and -0.084 for T2-weighted images. The comparison of values extracted by semi-automatic and automatic segmentations were highly correlated. Conclusions: Quantification of body composition values at MRI from T1-weighted and T2-weighted images was highly correlated to same values at CT, therefore quantitative values of body composition among ^ ORCID: 0000-0002-5151-0866.
Background: to evaluate the contribution of edema associated with histological features to the pr... more Background: to evaluate the contribution of edema associated with histological features to the prediction of breast cancer (BC) prognosis using T2-weighted MRI radiomics. Methods: 160 patients who underwent staging 3T-MRI from January 2015 to January 2019, with 164 histologically proven invasive BC lesions, were retrospectively reviewed. Patient data (age, menopausal status, family history, hormone therapy), tumor MRI-features (___location, margins, enhancement) and histological features (histological type, grading, ER, PgR, HER2, Ki-67 index) were collected. Of the 160 MRI exams, 120 were considered eligible, corresponding to 127 lesions. T2-MRI were used to identify edema, which was classified in four groups: peritumoral, pre-pectoral, subcutaneous, or diffuse. A semi-automatic segmentation of the edema was performed for each lesion, using 3D Slicer open-source software. Main radiomics features were extracted and selected using a wrapper selection method. A Random Forest type classif...
Bones are a frequent site of metastases that cause intolerable cancer-related pain in 90% of pati... more Bones are a frequent site of metastases that cause intolerable cancer-related pain in 90% of patients, making their quality of life poor. In this scenario, being able to treat bone oncology patients by means of minimally invasive techniques can be crucial to avoid surgery-related risks and decrease hospitalization times. The use of microwave ablation (MWA) is gaining broad clinical acceptance to treat bone tumors. It is worth investigating temperature variations in bone tissue undergoing MWA because the clinical outcomes can be inferred from this parameter. Several feasibility studies have been performed, but an experimental analysis of the temperature trends reached into the bone during the MWA has not yet been assessed. In this work, a multi-point temperature study along the bone structure during such treatment is presented. The study has been carried out on ex vivo bovine femur and tibia, subjected to MWA. An overall of 40 measurement points covering a large sensing area was obta...
Angiomyolipoma is a type of benign renal tumor. It is sporadic and isolated in 80% of cases. The ... more Angiomyolipoma is a type of benign renal tumor. It is sporadic and isolated in 80% of cases. The remaining 20% is associated with tuberous sclerosis complex or pulmonary lymphangioleiomyomatosis. Generally, angiomyolipomas manifest themselves as angiomyolipomatosis, in which the angiomyolipomas are larger, bilateral, and widespread. Understanding whether angiomyolipomas are present in the context of angiomyolipomatosis is of considerable importance because it might be associated with malignant lesions. This article provides an overview of the radiological features of renal angiomyolipomatosis under different imaging techniques such as ultrasound, computed tomography, and magnetic resonance.
European Journal of Surgical Oncology (EJSO), 2015
Objective-The aim of the present study was to assess the temperature map and its reproducibility ... more Objective-The aim of the present study was to assess the temperature map and its reproducibility while applying two different MWA systems (915 MHz vs 2.45 GHz) in ex vivo porcine livers. Materials and Methods-Fifteen fresh pig livers were treated using the two antennae at three different settings: treatment time of 10 minutes and power of 45 W for both systems; 4 minutes and 100 W for the 2.45 GHz system. Trends of temperature were recorded during all procedures by means of fiber optic-based probes located at five fixed distances from the antenna, ranging between 10 mm and 30 mm. Each trial was repeated twice to assess the reproducibility of temperature distribution. Results-Temperature as function of distance from the antenna can be modeled by a decreasing exponential trend. At the same settings, temperature obtained with the 2.45 GHz system was higher than that obtained with the 915MHz thus resulting into a wider area of ablation (diameter 17mm vs 15mm). Both systems showed good reproducibility in terms of temperature distribution (root mean squared difference for both systems ranged between 2.8 °C and 3.4 °C).
We present a case of double prosthetic replacement of the right pulmonary artery and superior ven... more We present a case of double prosthetic replacement of the right pulmonary artery and superior vena cava combined with upper sleeve bilobectomy for a limited pT4N1 adenocarcinoma occurring in a patient with poor pulmonary reserve, which, to the best of our knowledge, has never been reported before.
Bone metastases and osteoid osteoma (OO) have a high incidence in patients facing primary lesions... more Bone metastases and osteoid osteoma (OO) have a high incidence in patients facing primary lesions in many organs. Radiotherapy has long been the standard choice for these patients, performed as stand-alone or in conjunction with surgery. However, the needs of these patients have never been fully met, especially in the ones with low life expectancy, where treatments devoted to pain reduction are pivotal. New techniques as hyperthermia treatments (HTs) are emerging to reduce the associated pain of bone metastases and OO. Temperature monitoring during HTs may significantly improve the clinical outcomes since the amount of thermal injury depends on the tissue temperature and the exposure time. This is particularly relevant in bone tumors due to the adjacent vulnerable structures (e.g., spinal cord and nerve roots). In this Review, we focus on the potential of temperature monitoring on HT of bone cancer. Preclinical and clinical studies have been proposed and are underway to investigate the use of different thermometric techniques in this scenario. We review these studies, the principle of work of the thermometric techniques used in HTs, their strengths, weaknesses, and pitfalls, as well as the strategies and the potential of improving the HTs outcomes.
IEEE journal of electromagnetics, RF and microwaves in medicine and biology, 2024
Thyroid nodules represent a widespread health concern and surgery is often adopted even if the in... more Thyroid nodules represent a widespread health concern and surgery is often adopted even if the incidence of frequent post-operative complications is not negligible. In recent years, this framework has fostered the growing spread of thermal ablation treatments, in particular microwave ablation (MWA). To date, despite its relevance, state-of-the-art regarding temperature monitoring in thyroid tissue during MWA is lacking. In this paper, the effects of MWA in thyroid by monitoring temperatures have been explored. By using several fiber Bragg gratings (FBGs) temperature sensors, the heat maps in the proximity of the MW antenna have been reconstructed for two different power values set at generator. An increase up to about 4.5 cm 3 in ablation volume and up to 24°C in maximum temperature variation as power rises from 20 W to 30 W has been observed. In addition, the dependency of the temperature evolution on the involved power has been investigated, observing that, with increasing power, some FBGs recorded a ΔT slope increase until the maximum values, resulting in shorter ablation times, and others recorded a plateau phase until the end of the MWA treatment. Such a propensity could be relevant to adjust the clinical settings according to the desired treatment outcome.
Aim: To evaluate the capability of non-enhanced breast MRI to assess flap volume variability in p... more Aim: To evaluate the capability of non-enhanced breast MRI to assess flap volume variability in post-bariatric patients who underwent mastopexy in a reproducible way. Materials and Methods: Ten bariatric patients, treated with mastopexy using anterior intercostal artery perforator (AICAP) flap for autologous tissue breast augmentation, were enrolled in this study. All patients performed a breast Magnetic Resonance (MR) exam after surgery, in a period ranged from 177 and 838 days. The real flap volume, measured before mastopexy, and the flap volume calculated from MRI segmentation, was compared. Two radiologists performed the segmentation of the flap and of the whole breast, manually drawing an area of interest on MR images. The process was repeated for each patient, each breast and each slice 5 times, on axial T2W-TIRM, axial T1W-3D FS and sagittal T1W-3D images. Then, the flap and the breast 3D volumes were automatically generated combining multiple segmentations. The reproducibility of the measurements was evaluated, analyzing inter-and intra-observer agreement, and the most accurate MRI sequence was identified. Results: A significant difference between the mean flap volume before mastopexy and the mean MRI flap volume was detected, with an absolute mean decrease of 46,85% (105,89 cm 3) (p<0.05). There was no significant difference among the measurements performed by the same reader and by the two readers. The lowest variability was identified on T1W-FS, evaluated as the best performing sequences. Conclusion: MRI breast segmentation is an accurate and reproducible method for breast flap volume assessment and can provide important quantitative information to surgeons.
This article is an open access article distributed under the terms and conditions of the Creative... more This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY
This article is an open access article distributed under the terms and conditions of the Creative... more This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY
Background: The diffusion of lung cancer screening programs has increased the detection of both s... more Background: The diffusion of lung cancer screening programs has increased the detection of both solid and ground-glass opacity (GGO) sub-centimetric lesions, leading to the necessity for histological diagnoses. A percutaneous CT-guided biopsy may be challenging, thus making surgical excision a valid diagnostic alternative. CT-guided hydrogel plug deployment (BioSentry®) was recently proposed to simplify intraoperative nodule localization. Here, we report our initial experience. Methods: We evaluated 62 patients with single, small, peripheral, non-subpleural pulmonary GGO that was suspicious for cancer. All lesions were preoperatively marked, using CT-guidance, with a hydrogel plug (BioSentry®). Then, a uniportal video-assisted thoracoscopy (uniVATS) wedge resection was performed. If cancer was confirmed at the frozen section, a major lung resection was then performed. The study’s end points were the rates of intraoperative localization and of successful resection. Results: The hydro...
This article is an open access article distributed under the terms and conditions of the Creative... more This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY
Background: Percutaneous CT-guided cryoablation is an emerging technique for treating bone tumors... more Background: Percutaneous CT-guided cryoablation is an emerging technique for treating bone tumors. However, experience with using this procedure for osteoid osteomas in pediatric patients remains limited. Our study aims to assess its technical feasibility, clinical efficacy, and safety in children treated under conscious anesthesia. Methods: We conducted a retrospective study of consecutive pediatric patients who underwent CT-guided percutaneous cryoablation for osteoid osteomas at our institution between September 2017 and March 2021. All patients received conscious anesthesia. Data on peri-procedural VAS scores, post-procedural VAS scores, imaging findings, and nonsteroidal anti-inflammatory drug (NSAID) usage rates were collected for each patient. Technical success was defined as proper cryoprobe placement at the nidus center, while clinical success referred to pain relief without NSAID use. Intra- and post-operative complications were also evaluated. Results: Nine patients under...
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Papers by Rosario Grasso